The Characteristics of Patients and Recurrence Patterns in Patients with Hepatocellular Carcinoma Treated with Radio-frequency Ablation

Lee, Seong Dae; Kim, Chan Young; Yu, Hee Chul; Lee, Jeong Min; Kim, Dae Ghon; Cho, Baik Hwan

Abstract

BACKGROUND/AIMS: The purpose of our study was to describe the characteristics of patients and recurrence patterns in patients with hepatocellular carcinoma (HCC) treated with radio-frequency ablation (RFA). Those were expected little different in some aspects from that in patients treated with surgical ablation (SA).
METHODS
One hundred and twenty-five patients with HCC underwent RFA (Thermal Ablation, TA) between March 1, 1998 and May 31, 2001. Out of these, fifty-seven patients who were amenable to TA as a primary treatment, because of various reasons, were enrolled. Forty-eight patients were underwent SA due to HCC during the same period of time.
RESULTS
The patients in the TA group exhibited more frequent ascites (p<0.001) and higher level of serum bilirubin (p<0.001) than SA group. As of April 31 2002, 22 patients (39%) who underwent TA and 7 patients (15%) who underwent SA have had intrahepatic and/or extrahepatic recurrent diseases. The patients in the TA group exhibited higher intrahepatic recurrence rate (p=0.02) and the time to recurrent disease was significantly shorter (p=0.003) than the patients in the SA group. Intriguingly the 28 patients who do not had a history of ascites in the TA group exhibited higher recurrence rate (p=0.011) than those of SA group. The recurrence rate of TA group in patients with diameter less than 3.5 cm was also higher than SA group (p=0.013). Moreover the recurrence rate of AFP producing tumors in the patients of TA was significantly higher than that of SA (p=0.033).
CONCLUSION
TA results in higher rate of recurrence (intrahepatic and extrahepatic) even in patients with relatively small HCC (< or =3.5 cm) and normal liver functions. The time to recurrent disease is shorter in TA group than SA group of patients. Interestingly the recurrence rate of AFP producing tumors (>15 ng/ml) in the patients of TA was significantly higher than that of SA.